Background and Design: Bullous pemphigoid is a rare autoimmune blistering disease. The aim of this study was to investigate the epidemiological characteristics and clinical, laboratory, and radiological features of patients with bullous pemphigoid in Erzurum and to evaluate the association of bullous pemphigoid with comorbid diseases. Methods and Methods: Medical records of 38 patients, who were diagnosed with bullous pemphigoid after biopsy and hospitalized in our clinic between 2003 and 2013, were retrospectively studied. Results: Fifteen (39.5%) of the 38 patients were male, and 23 (60.5%) were female. The mean age at the time of diagnosis was 62.4±21 years. Analyses of the results of direct immunofluorescence showed that the most common finding was the presence of IgG and C3 (42.1%). The average time since the first presentation until diagnosis was 72.7±104.3 days. The mean initial dose of corticosteroid was 54.7±26.01 mg/ day. The mean length of hospitalization for bullous pemphigoid was 22.6±23.5 days. We did not detect any malignancy or comorbid diseases associated with bullous pemphigoid. However, eosinophilia was detected. Conclusions: Routine laboratory and radiological investigations are not necessary to detect malignancy in patients with bullous pemphigoid. (Turkderm 2015; 49: 66-9)

Background/aim: Psoriasis is an immune-mediated chronic inflammatory skin disease that is seen in 1%-3% of the population. It is characterized by symmetrical papulosquamous lesions on the scalp, knees, elbows, sacral region, and extensor surfaces of the extremities. Psoriasis affects both sexes equally. It is thought that reactive oxygen species have an important role in inflammatory skin diseases, especially in psoriasis. There are few studies investigating serum oxidant-antioxidant levels in psoriasis. In this study, we aimed to investigate serum oxidant and antioxidant levels in psoriasis and their effects on its pathogenesis. Materials and methods:Included in this study were 50 patients with psoriasis who had not been treated with any systemic medication and 45 healthy volunteers (control group). The total oxidant status (TOS), total antioxidant status (TAS), malondialdehyde (MDA), and 8-hydroxy 2'-deoxyguanosine (8H2D) were studied via venous blood sampling. The parameters were measured spectrophotometrically. The study was approved by the Local Ethics Committee of the Atatürk University Faculty of Medicine. Results:The mean ages of the patients and control group were 32.48 (±14.45) and 35.64 (±17.40) years, respectively. Of the patients, 23 were male and 27 were female. Of the healthy volunteers, 20 were male and 25 were female. The mean disease duration was 8.77 (±6.90) years. The mean Psoriasis Area and Severity Index (PASI) score was 11.41 (±9.62). The mean TOS levels of the patient and control groups were 63.12 (±33.23) and 4.50 (±9.74), respectively. This difference was statistically significant (P = 0.00). The mean TAS levels of the patient and control groups were 3.15 (±0.70) and 3.16 (±0.44), respectively, without any statistically significant difference. The mean MDA levels in the patient and control groups were 14.84 (±6.66) and 12.77 (±4.87), respectively, without any statistically significant difference. The mean 8H2D levels of the patient and control groups were 16,781.2 (±5918.95) and 15,276.13 (±6084.95), respectively. This difference was also not statistically significant. There was no correlation between PASI scores and the above-mentioned parameters. Conclusion:In the present study, the TOS levels showed a significant statistical difference between the psoriasis and control groups. This finding supports the effect of the oxidant system in the pathogenesis of psoriasis. This was the first study to investigate MDA, TOS, TAS, and 8H2D levels together in patients with psoriasis. More studies are needed to clearly understand the relationship between psoriasis and the oxidant-antioxidant system.

Phyto contact dermatitis is a skin reaction caused by plants. Allergic

Background and Design:Pemphigus is a severe and life-threatening chronic autoimmune mucocutaneous blistering disease. The aim of this study was to evaluate and analyze the course, prognostic factors and epidemiological, clinical and therapeutic features of pemphigus in patients followed between 2004 and 2013. Materials and Methods: We performed a 10-year retrospective study of patients diagnosed with pemphigus in Erzurum. The parameters that were evaluated include age, sex, diagnostic methods, duration of hospitalizations, distribution of lesions, duration of treatment and therapeutic doses. Results:The results showed that the estimated annual incidence rate was 1.31 cases per 100.000 person-years. The male to female ratio was 1: 0.81. The mean age at onset of the disease was 48 years (range: 7-95 years). Thirty-six patients had only skin lesions and sixty-six cases had both skin and oral mucosal lesions. The majority of the patients (58.8%) with pemphigus were treated with middle or high-dose corticosteroids (40-160 mg/day). Conclusions: Pemphigus vulgaris is the most common clinical subtype in Erzurum and the mean age of the disease onset in the present study was found to be a decade earlier than in other parts of the world. The patients with both oral mucosa and skin involvement required higher corticosteroid doses and longer hospitalization time when compared to the patients with oral mucosa involvement alone. (Turkderm 2015; 49: 125-8)

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Kaposi sarcoma is a vascular tumor associated with Human Herpes Virus-8 infections. Lesions predominantly present at mucocutaneous sites but may involve all organs. There are many kinds of Kaposi sarcoma variants. Pyogenic granuloma like Kaposi sarcoma is a new variant which protrudes from skin and resembles a pyogenic granuloma. We decided to report two cases of Kaposi sarcoma because there are only few case reports about pyogenic granuloma like Kaposi sarcoma in literature, which is usually misdiagnosed as pyogenic granuloma.

Case HistoryA 19-years-old strawberry picker man was admitted to our clinic with severe vesicular and bullous lesions accompanied with complaints of intensely itching and burning. Lesions were on erythematous base and localized on his both legs (Fig. 1). He had worked in strawberry field approximately 12 hours before onset of lesions. The lesions were limited to uncovered contact area with the leaves. He had applied a nitrogen based liquid fertilizer to the strawberry leaves and shortly after had begun to work in the field. He had a continuously contact with the leaves while he was working. Patient has no history of any allergy, medication or disease include contact or food allergy to the strawberry and strawberry leaves. Patch test was not performed because patient denied. Laboratory investigations were completely with in normal limits. No any microorganism detected in cultures obtained from blisters fluid. Histological examination of biopsy specimen showed lack of epidermis and mixed inflammatory infiltrate of lymphocytes in superficial dermis (Fig. 2). Direct immunofluorescence staining was negative. Based on these findings, we made a diagnosis of irritant contact dermatitis due to nitrogen based fertilizer. Patient treated with a short tapering course of systemic methylprednisolone (40 mg/day, tapered by 5 mg/day), topical wed dressing and topical antibiotic. The lesions resolved completely in 25 days without any complication. DiscussionFarmers are exposed to many skin damaging factors. In a study that include 132 farmers of diagnosed with contact dermatitis, causes of 13 percent were found to be chemical irritants such as fertilizers, pesticides etc.

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